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What Depression Does to Our Minds When It Attacks

After two of my acquaintances died on the same day in the same way—by shooting themselves—I heard various comments:

“But he was such a strong Christian! How could he do this?”

“I guess he took the easy (or, ‘the coward’s’) way out.”

“He wasn’t thinking about his family at all, that’s for sure!”

“Well, I always thought only losers had depression, like people living on the street, or alcoholics and drug addicts – nobody but losers!”

None of the people who said these things understood depression at all or what it can do to anybody.

I’ve been a journalist, a college teacher in Hong Kong, and—for 22 years—a pediatrician. I was chief of staff and a trustee at a
700-plus bed medical center with 2 campuses and 400 doctors. I am a dedicated Christian, a Presbyterian elder, and a veteran
of medical mission trips to the Amazon. I speak fluent Spanish, some Portuguese, a little German, and a bit of Cantonese.
When I am thinking rationally, I can see that I am intelligent, witty, well-liked and respected.

I also have battled depression for more than 40 years, and when I am depressed, I do think I am a complete loser.

I have been so depressed that I have considered killing myself many times. I decided 30 years ago that I could never safely
own a firearm because I knew what I would do with it someday. Even so, I have come close to buying a gun. A few years ago,
I had extremely severe, treatment-resistant depression—an epoch more than an episode—that lasted several years and steadily
worsened despite multiple medicines and weekly visits to my psychiatrist. Eventually, I did go shopping for a pistol.
With great difficulty, I chose not to buy it and committed myself to the hospital instead.

I had extreme depression— much more severe than that endured by the great majority of people who become depressed.
Most need only counseling and perhaps medicine to become happy once more. They don’t lose their jobs or have to be admitted to
hospitals, and they do not come close to killing themselves. Unfortunately, most who are depressed do not seek any help—often
because they fear what others will think. This is a mistake, because effective help is available.

I too was afraid of the stigma and of being labeled a loser. Until I entered the hospital for intense treatment, I hid my depression as
long as possible. I was afraid others would think me weak instead of strong, think there was something “wrong” with me, that I was
broken and could not be “fixed.” I feared they would believe I could not be an effective physician if they knew I had depression.

I also have a stubborn independent streak. I believed that I could “handle it”—a trait common among physicians. We see a problem and
we fix it. Before I ended up in the hospital, I (eventually) let only my partners, my pastor, and a few close friends know that I was seeing a psychiatrist and taking medicine. No one in my own family knew. I was too ashamed to tell anyone I had a mental illness. /.../